Laser Eye Surgery – A Patient’s Diary
Cataract Surgery From 500Bc Till Today
Being one of the oldest surgical procedures in medicine, cataract surgery has certainly came a long way from the procedures described in Sanskrit manuscripts dating from the 5th century BC by the ancient Indian surgeon Shusruta. In this procedures called “couching”, the lens was simply dislodged to the back of the eye and left there. The results were patients who could make out colours and shapes (if their eye sight wasn’t lost completely) – certainly much better than no vision at all!
In the 18th century surgeons started to remove the lens (with cataract formation) from the eye, it was only in the middle of the 19th century that anaesthesia were used for cataract surgery for the 1st time. Up till then the surgery were performed by pinning the patient down to the operating table or chair!
The initial lens removal surgeries were quite crude with complications seen very often. Incisions as big as 12 to14 centimetres were performed to remove the lens as a whole. That was followed by leaving the patient on his or her back with sandbags around the head to prevent any movement for at least 14 days (Since there were no sutures small enough to suture an eye, the eye had to heal on its own).
During the last 2 or 3 decades this part of the cataract surgery became much more elegant and predictable. Surgeries are generally done through an incision of around 2 mm using a sophisticated ultrasound probe to break the lens into small pieces and to extract from the eye – all while a constant pressure and low energy environment are maintained inside the eye. This procedure is called micro incision phaco-emulsification.
Rehabilitating the vision after removing the lens was a big problem and was only solved in the 1940’s by an English surgeon Sr. Harold Ridley. He acted on the knowledge gained in World War 2 where it was found, that glass penetrating the eyes of fighter pilots, showed little or no reaction inside the eye. In other words, the glass was not rejected by the body. This knowledge sparked the idea of implantation of a lens inside the eye. Sr. Harold designed the first lenses and implanted them with some success. This was the beginning of the concept of “intra-ocular lenses” (IOL’s).
IOL’s evolved very quickly into a multi-million dollar industry producing extremely accurate and technologically advanced lenses usually leaving patients with excellent vision after a cataract operation. The modern lens removal technology combined with the new generation of intra-ocular lenses that is implanted directly after the removal of the lens (through the same small incision) ensures a relatively pain free procedure with the patient able to continue with normal activity almost immediately after the procedure.
Contact us to make an appointment to assess your suitability for cataract surgery.
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